Abstract:

Background: Exercise referral programmes (such as the Green Prescription community programme) are a popular and effective way of increasing the physical activity of primary care patients who at risk of, or diagnosed with, chronic disease. The perspectives of patients in regards to their health behaviours are important for refining the strategies employed in such interventions.

Aim: This study aimed to explore how patients participating in the Green Prescription programme understood the concept of success in terms of their physical activity and health. It also aimed to demonstrate how this understanding may change over time.

Research Design: Qualitative longitudinal data was collected from fourteen patients attending the community programme. This was achieved by using two phases of semi-structured interviews conducted five months apart. The verbatim interview transcripts were analysed using thematic analysis, and them triangulated with routine information recorded on Green Prescription patient registration forms. This information was then used to generate themes.

Findings: When considering goals for the future, patients described success in terms of avoiding or managing disease states and clinical measures such as blood glucose level or blood pressure. In the second interviews, these factors were rarely considered as achievements, even when progress had been made. The themes relating to establishing physical activity as a habit and improvement of functional ability and physical fitness were described as experiences of success and achievement in the second interviews, even when they had not been specified as goals in the first interviews.

Conclusion: The conceptualisations of success more likely to lead to experiences of success may be of value when promoting physical activity among inactive primary care patients referred to programmes such as Green Prescription. These findings suggest that framing physical activity goals around improving functional ability and physical fitness are more likely to result in patients embracing a more active lifestyle. Conversely, goals that focus on clinical measures and the threat of disease are potentially detrimental to behaviour change attempts.